Vasculitis: approach to diagnosis and therapy.

Vasculitides is a group of disorders characterized by inflammation of vessel walls. The unique feature of this group is multi-organ involvement. Because of the rich vasculature, the skin is prone to be frequently affected in vasculitis. Cutaneous involvement in vasculitides may be primary or reflector of a fatal systemic disease or evidence of association with some other systemic disorder. Sometimes there may be subtle cutaneous lesions and predominant systemic involvement. These cases may present initially to other specialties, depending on the major organ of manifestation. Misdiagnosis is frequent in these situations; cases of acute abdomen, undergoing emergency exploratory laparotomy, later diagnosed as cutaneous small vessel vasculitis (CSVV), is not uncommon. Sometimes it may be necessary to assess a patient’s extent of organ involvement in several steps through clinical and laboratory examinations. Hence a systematic approach is required for diagnosis and management of these multi-system disorders.